结构化食物序列和移动健康监测对妊娠期糖尿病结局的影响：一项临床试验。
Impact of a structured food sequence and mobile health monitoring on gestational diabetes outcomes: a clinical trial.
作者信息
Murugesan Ria, Thiruselvam Shubhashree, Leela Kakithakara Vajravelu, Satheesan Abhishek, Geetha K, Ram Mohan, Kumar Janardanan
机构信息
Department of Microbiology, SRM Medical College Hospital and Research Centre, SRM IST, Kattankulathur, Tamil Nadu, India.
Department of Obstetrics and Gynecology, SRM Medical College Hospital and Research Centre, SRM IST, Kattankulathur, Tamil Nadu, India.
出版信息
Front Nutr. 2025 Jul 28;12:1562240. doi: 10.3389/fnut.2025.1562240. eCollection 2025.
BACKGROUND
Gestational Diabetes Mellitus (GDM) is a common pregnancy complication that poses risks to both mother and baby. Dietary management is crucial in controlling blood glucose, and recent evidence suggests that the order in which food is consumed (food sequencing) can improve glycemic control. Mobile health (mHealth) tools also offer promising support for healthier eating habits and glucose monitoring. This study evaluates whether combining a structured food sequence with mHealth monitoring enhances outcomes in women with GDM.
METHODS
Fifty-four pregnant women diagnosed with GDM were randomized into an intervention group ( = 27) and a control group ( = 27). The intervention group followed a structured food order-fiber first, then protein, and carbohydrates last-and tracked their intake using a mobile health application (JotForm). The control group received standard antenatal care without food sequencing. Fasting and postprandial glucose, lipid profiles, hemoglobin, and pregnancy outcomes were measured at baseline, the end of the third trimester, and 4 weeks postpartum. Data analysis included paired and independent -tests or non-parametric equivalents, with chi-square tests for categorical variables. A -value <0.05 was considered statistically significant.
RESULTS
The intervention group showed significant reductions in 1-h and 2-h postprandial blood glucose levels (-8.41 mg/dL and -7.56 mg/dL respectively, both < 0.001), decreased LDL cholesterol (-7.33 mg/dL, < 0.001), increased HDL cholesterol (+6.15 mg/dL, < 0.001), and improved hemoglobin levels. They also had more normal deliveries (13 vs. 10) and fewer cases of shoulder dystocia (2 vs. 5) compared to controls. Additionally, this group exhibited lower average birth weights, fewer NICU admissions, and reduced neonatal complications.
CONCLUSION
Combining a structured food sequencing approach with mHealth dietary monitoring improved maternal glycemic control and pregnancy outcomes in women with GDM. This strategy shows promise for supporting dietary adherence and managing GDM effectively, warranting further research to validate its broader application.
CLINICAL TRIAL REGISTRATION
https://ctri.nic.in/Clinicaltrials/main1.php?EncHid=93509.81482, identifier CTRI/2024/01/061220.
背景
妊娠期糖尿病（GDM）是一种常见的妊娠并发症，对母婴均构成风险。饮食管理对于控制血糖至关重要，最近的证据表明食物的进食顺序（食物排序）可改善血糖控制。移动健康（mHealth）工具也为更健康的饮食习惯和血糖监测提供了有前景的支持。本研究评估将结构化食物顺序与mHealth监测相结合是否能改善GDM女性的结局。
方法
54名被诊断为GDM的孕妇被随机分为干预组（n = 27）和对照组（n = 27）。干预组遵循结构化食物顺序——先纤维，再蛋白质，最后碳水化合物——并使用移动健康应用程序（JotForm）跟踪其摄入量。对照组接受标准产前护理，不进行食物排序。在基线、孕晚期结束时和产后4周测量空腹和餐后血糖、血脂谱、血红蛋白及妊娠结局。数据分析包括配对和独立t检验或非参数等效检验，分类变量采用卡方检验。P值<0.05被认为具有统计学意义。
结果
干预组餐后1小时和2小时血糖水平显著降低（分别降低8.41mg/dL和7.56mg/dL，均P<0.001），低密度脂蛋白胆固醇降低（降低7.33mg/dL，P<0.001），高密度脂蛋白胆固醇升高（升高6.15mg/dL，P<0.001），血红蛋白水平改善。与对照组相比，他们的顺产次数更多（13次对10次），肩难产病例更少（2例对5例）。此外，该组平均出生体重更低，新生儿重症监护病房（NICU）收治人数更少，新生儿并发症减少。
结论
将结构化食物排序方法与mHealth饮食监测相结合可改善GDM女性的母体血糖控制和妊娠结局。该策略在支持饮食依从性和有效管理GDM方面显示出前景，值得进一步研究以验证其更广泛的应用。
临床试验注册
https://ctri.nic.in/Clinicaltrials/main1.php?EncHid=93509.81482，标识符CTRI/2024/01/061220。
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